Boat, RV & Motorcycle Insurance Quote
 

“ In order to get a prompt, accurate quote and to lock in the discounts you are entitled to, please answer the questions below. We keep all information you give us private and confidential.  We will contact you within 24 hours!"
 

"We can save you up to 41% on all types of vehicles such as Boats, Motor homes, motorcycles, ATv's , Travel trailers and Snowmobiles!"
     
First Name
 MI
 Last Name
Street Address
 Apt. #
  
City
 State
 Zip
Phone#
 Best time to contact
 Fax #
E-mail Address
    
     
Boat / RV / Motorcycle Description  
Boat / RV / Motorcycle #1    
Year
 Make
 Model
Current value of RV / Motorcycle / Boat including trailer
Horsepower of Boat
 Type of Boat
 
Type of RV
 Type of Motorcycle
 CC's of Motorcycle
Boat / RV / Motorcycle #2    
Year
 Make
 Model
Current value of RV / Motorcycle / Boat including trailer
Horsepower of Boat
 Type of Boat
 
Type of RV
 Type of Motorcycle
 CC's of Motorcycle
     
Driver Information    
Driver #1    
Name
 Marital Status
Date of Birth
, 		Sex
   
Driver #2    
Name
 Marital Status
Date of Birth
, 		Sex
   

Please list all traffic violations within 3 years and any accidents for
all driver listed (please include accidents deemed not-at-fault)
     
Do you own a home?
Yes  No		 If renting, do you have a renter's policy?
Yes  No		  
     
Current Coverage's    
What company are you
currently insured with?
 What is the expiration
date of your policy?
What is your current annual premium?
 Bodily injury Liability Limit
Watercraft Liability Limit
 Uninsured Motorist Liability Limit
Personal Injury Protection
 RV Towing Coverage
Yes  No 
Comprehensive Deductible  
        Boat / RV / Motorcycle #1   #2  

 

Any other information you feel that is pertinent to your Boat / RV / Motorcycle policy?
     

"Thank you for filling out this form for a quote.
We will contact you within 24 hours!"

     

 
     

Black & Associates Insurance Inc
8605 N. Division  Spokane, WA
Citywide Call: 1-509-464-0058
Out of Area Call: 1-800-576-0075
info@jbbinsurance.com

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